Perceptual-motor skill learning in Gilles de la Tourette syndrome. Evidence for multiple procedural learning and memory systems.

Procedural learning and memory systems likely comprise several skills that are differentially affected by various illnesses of the central nervous system, suggesting their relative functional independence and reliance on differing neural circuits. Gilles de la Tourette syndrome (GTS) is a movement disorder that involves disturbances in the structure and function of the striatum and related circuitry. Recent studies suggest that patients with GTS are impaired in performance of a probabilistic classification task that putatively involves the acquisition of stimulus-response (S-R)-based habits. Assessing the learning of perceptual-motor skills and probabilistic classification in the same samples of GTS and healthy control subjects may help to determine whether these various forms of procedural (habit) learning rely on the same or differing neuroanatomical substrates and whether those substrates are differentially affected in persons with GTS. Therefore, we assessed perceptual-motor skill learning using the pursuit-rotor and mirror tracing tasks in 50 patients with GTS and 55 control subjects who had previously been compared at learning a task of probabilistic classifications. The GTS subjects did not differ from the control subjects in performance of either the pursuit rotor or mirror-tracing tasks, although they were significantly impaired in the acquisition of a probabilistic classification task. In addition, learning on the perceptual-motor tasks was not correlated with habit learning on the classification task in either the GTS or healthy control subjects. These findings suggest that the differing forms of procedural learning are dissociable both functionally and neuroanatomically. The specific deficits in the probabilistic classification form of habit learning in persons with GTS are likely to be a consequence of disturbances in specific corticostriatal circuits, but not the same circuits that subserve the perceptual-motor form of habit learning.